H1N1 and Pandemic Preparedness

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H1N1 and Pandemic Preparedness

• Pam Johnson, B.Sc. Pharm.

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Objectives

• Role of the Pharmacist
• Pandemic Action Plan
• Resources
• Pandemic Planning
• Up-to-date H1N1 Information
• Summary

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The Role of a Pharmacist

• Pharmacists are the most accessible front line
  healthcare professionals
• Critical role to play
• You can make a difference

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The Role of the Pharmacist

• Provide concise and up-to-date information to the
  public
• Alert public health officials of potential
  outbreaks
• Triage and patient referral, communication, and
  planning

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The Role of the Pharmacist

• Triage and Patient Referral
• Ensure the sick stay away from the healthy
• Manage patients with minor illnesses
• Counsel and educate on symptoms
• What to watch for
• How to treat
• When to refer

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The Role of the Pharmacist

• Triage and Patient Referral
• Vaccinations
• Public health will lead the initiative
• Pharmacist responsibilities
• Screening
• Patient education
• Counseling and follow-up
• Reassess the dispensing process and technician
  task allocation

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The Role of the Pharmacist

• Communication
• Maintain communication with public health and the
  MPhA to ensure that we provide accurate
  information to the public
• Familiarize colleagues with your pandemic plan
• understand responsibilities before, during and
  after a pandemic
• Keep list of resources available for most current
  information

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The Role of the Pharmacist

• Stay in touch with your community
• Be aware of regional planning initiatives
• Discuss how your pharmacy team will be involved
  with these plans
• Preparing is essential
• The more you are prepared, the better able you
  are to cope with the economic, social and
  environmental strains when the pandemic influenza
  strikes

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Develop a Pandemic Plan

• What needs to be considered?

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Prevention

• Promote Health Strategies to Protect Patients,
  Family Members and Yourself
• Wash your hands and wash often
• Use alcohol-based hand rubs
• Frequent cleaning of surfaces
• Cough and sneeze into your arm
• Avoid touching eyes, nose, mouth
• Face masks

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Prevention

• Promote Health Strategies to Protect Patients,
  Family Members and Yourself
• Flu-like symptoms? STAY HOME
• Contact your physician
• If pregnant
• Have underlying health problems
• Experience shortness of breath
• Maintain healthy lifestyle
• Drink plenty of fluids and get lots of rest
• Do not share food or drinks
• Get a flu shot
• Be ready

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Public Education

• Recognize flu symptoms
• Adhere to prevention strategies
• Counsel patients how to avoid/treat flu
• Watch for patients seeking herbal remedies
• Distribute patient handouts
• Know when to refer
• Share your pandemic plan with colleagues

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Public Education - Useful Information

• Incubation Period
• 1-4 days, possibly up to 7 days
• Transmission
• 1 day before symptoms up to 7 days after symptom
  onset
• Worst Illness
• 1st 4 days for adults
• 3 days or less for children
• Hard Surfaces
• Lives 24-48 hours, infectious for only 2-8 hours
• Soft Surfaces
• Lives 8-12 hours, infectious for a few minutes

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Public EducationSymptoms of the Flu Virus (H1N1
and Seasonal)

• Almost always
• Sudden onset of fever and cough
• Common
• Fatigue
• Muscle aches
• Sore throat
• Headache
• Decreased appetite
• Runny nose
• Sometimes
• Nausea
• Vomiting
• Diarrhea

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Public Education When Should you Refer?
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Public EducationSeverity Indicators

• See a Physician
• SHORTNESS OF BREATH at any time, rapid or
  difficulty breathing
• If symptoms become a lot worse over 2-3 days
• Chest pain
• Asthma symptoms worsen
• Bluish or grey skin color

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Public EducationSeverity Indicators

• See a Physician
• Bloody or coloured mucus/spit
• Sudden dizziness or confusion
• Severe or persistent vomiting
• High fever 3 days
• Low blood pressure

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Public EducationSeverity Indicators

• See a Physician
• Additional symptoms to watch for in children
• Fever does not subside with medication
• Lethargic, irritable
• Not eating/drinking
• Not waking up or interacting

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Labour

• Who will look after children if sick or if
  schools are closed?
• Who will care for the older adults?
• If 25 of the staff are sick, how will hours be
  re-allocated?
• Will colleagues be available to work during a
  pandemic?
• Are staff cross-trained on duties or available
  from other parts of the business?
• Contract relief available

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Hours of Operation

• Are current hours of operation sustainable?
• Plan in advance
• How will a change be communicated to the public ?
• Website, brochures/posters, flyers, IVR
• Rural locations
• One pharmacist stores are at risk
• How will patients get prescriptions?
• Central fill? Another store?

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Communication Protocol

• How will you provide updated information to
  colleagues?
• Email, Sharepoint
• Communicate with other pharmacies in the area as
  well as health care workers
• Maintain an up-to-date contact list
• Telephone, email, cell, emergency contact
• How will scheduling changes be communicated?

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Security

• Determine where emergency passwords will be
  located or distributed
• Computer, alarm codes, till passwords
• Access to the store/pharmacy
• Key to dispensary
• Lock and leave
• Narcotic cabinet

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Identify Critical Activities

• Prioritize Rxs
• How? Who comes first?
• How will this be communicated to employees?
• Counselling Priorities
• Antivirals? Antibiotics?
• Only those who have questions
• Counselling on chronic meds
• Determine operational priorities
• A diabetes educational event would not be a
  priority during a pandemic event

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Inventory

• Maintain adequate supply of chronic medication
• Dont wait until the last minute
• Ensure your pharmacy is
• adequately stocked
• Review top 100 drugs and
• readjust reorder points
• Dont neglect the front store
• analgesics
• Province will intervene only if there is a
  shortage of stock
• a problem is not anticipated

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Vendors

• Vendors should prioritize pharmacy destinations
• Drivers should take deliveries directly to the
  pharmacy if possible
• What if local distribution center closes?
• How will delivery discrepancies impact your store?